Associations of Serum Vitamin B6 Status with the Risks of Cardiovascular, Cancer, and All-cause Mortality in the Elderly

Overview

Journal Front Immunol

Specialty Allergy & Immunology

Date 2024 May 3

PMID 38698865

Authors

Pengxi Wang

Jia Huang

Feng Xue

Munire Abuduaini

Yuchang Tao

Hongyan Liu

Affiliations

Soon will be listed here.

Abstract

Background: There are few studies investigating the relationship between serum vitamin B6 and mortality risk in the elderly. This study hereby evaluated the associations between biomarkers of serum vitamin B6 status and cardiovascular, cancer, and all-cause mortality risks in the elderly.

Methods: Our study included a total of 4,881 participants aged 60 years or older from the National Health and Nutrition Examination Survey (NHANES) 2005-2010. Serum vitamin B6 status was estimated based on levels of pyridoxal 5'-phosphate (PLP), 4-pyridoxic acid (4-PA), and vitamin B6 turnover rate (4-PA/PLP) detected by high-performance liquid chromatography. Survival status and corresponding causes of death were matched through the National Death Index records through December 31, 2019. Multivariate Cox regression model was adopted to assess the relationships between serum vitamin B6 status and the risk of mortality.

Results: During a median follow-up period of 10.33 years, 507 cardiovascular deaths, 426 cancer deaths, and 1995 all-cause deaths were recorded, respectively. In the multivariate-adjusted Cox model, the hazard ratios (HRs) and 95% confidence intervals (CIs) for the highest versus the lowest quartiles of PLP, 4-PA, and 4-PA/PLP were 0.70(0.54-0.90), 1.33(0.88-2.02), and 2.01(1.41-2.79) for cardiovascular mortality, 0.73(0.52-1.02), 1.05(0.71-1.57), and 1.95(1.25-3.05) for cancer mortality, and 0.62(0.53-0.74), 1.05(0.82-1.34), and 2.29(1.87-2.79) for all-cause mortality, respectively.

Conclusion: Our study found that lower serum PLP levels were associated with increased risks of cardiovascular and all-cause mortality among the elderly population. And higher vitamin B6 turnover rate was associated with increased risks of cardiovascular, cancer, and all-cause mortality.

Citing Articles

Vitamin B6 status, type 2 diabetes mellitus, and periodontitis: evidence from the NHANES database 2009-2010.

Zhu J, Xu W, Wu S, Song D BMC Oral Health. 2025; 25(1):299.

PMID: 39994649 PMC: 11852513. DOI: 10.1186/s12903-025-05597-z.

MR1 presents vitamin B6-related compounds for recognition by MR1-reactive T cells.

McInerney M, Awad W, Souter M, Kang Y, Wang C, Chan Yew Poa K Proc Natl Acad Sci U S A. 2024; 121(49):e2414792121.

PMID: 39589872 PMC: 11626183. DOI: 10.1073/pnas.2414792121.

Serum Pyridoxal 5'-Phosphate and Pyridoxic Acid Ratio Index with Prognosis of Colorectal Cancer: A Prospective Cohort Study.

Li X, Xu L, Ou Q, Xu H, Chen Y, Fang Y Nutrients. 2024; 16(21).

PMID: 39519518 PMC: 11547691. DOI: 10.3390/nu16213685.

The Interplay between Liver and Adipose Tissue in the Onset of Liver Diseases: Exploring the Role of Vitamin Deficiency.

Tattoli I, Mathew A, Verrienti A, Pallotta L, Severi C, Andreola F Cells. 2024; 13(19.

PMID: 39404394 PMC: 11475612. DOI: 10.3390/cells13191631.

Does Vitamin B6 Act as an Exercise Mimetic in Skeletal Muscle?.

Kato N, Yang Y, Bumrungkit C, Kumrungsee T Int J Mol Sci. 2024; 25(18).

PMID: 39337450 PMC: 11432312. DOI: 10.3390/ijms25189962.

References

Zhang Z . Multiple imputation with multivariate imputation by chained equation (MICE) package. Ann Transl Med. 2016; 4(2):30. PMC: 4731595. DOI: 10.3978/j.issn.2305-5839.2015.12.63. View

Casciato D, McAdam L, Kopple J, Bluestone R, Goldberg L, Clements P . Immunologic abnormalities in hemodialysis patients: improvement after pyridoxine therapy. Nephron. 1984; 38(1):9-16. DOI: 10.1159/000183270. View

Stanger O, Herrmann W, Pietrzik K, Fowler B, Geisel J, Dierkes J . DACH-LIGA homocystein (german, austrian and swiss homocysteine society): consensus paper on the rational clinical use of homocysteine, folic acid and B-vitamins in cardiovascular and thrombotic diseases: guidelines and recommendations. Clin Chem Lab Med. 2003; 41(11):1392-403. DOI: 10.1515/CCLM.2003.214. View

Schorgg P, Karavasiloglou N, Beyer A, Cantwell M, Danquah I, Gojda J . Increased vitamin B6 turnover is associated with greater mortality risk in the general US population: A prospective biomarker study. Clin Nutr. 2022; 41(6):1343-1356. DOI: 10.1016/j.clnu.2022.04.023. View

Midttun O, Hustad S, Schneede J, Vollset S, Ueland P . Plasma vitamin B-6 forms and their relation to transsulfuration metabolites in a large, population-based study. Am J Clin Nutr. 2007; 86(1):131-8. DOI: 10.1093/ajcn/86.1.131. View

Ulvik A, Midttun O, Pedersen E, Eussen S, Nygard O, Ueland P . Evidence for increased catabolism of vitamin B-6 during systemic inflammation. Am J Clin Nutr. 2014; 100(1):250-5. DOI: 10.3945/ajcn.114.083196. View

Johansson M, Fanidi A, Muller D, Bassett J, Midttun O, Vollset S . Circulating biomarkers of one-carbon metabolism in relation to renal cell carcinoma incidence and survival. J Natl Cancer Inst. 2014; 106(12). PMC: 4273895. DOI: 10.1093/jnci/dju327. View

Barkoukis H . Nutrition Recommendations in Elderly and Aging. Med Clin North Am. 2016; 100(6):1237-1250. DOI: 10.1016/j.mcna.2016.06.006. View

Hellmann H, Mooney S . Vitamin B6: a molecule for human health?. Molecules. 2010; 15(1):442-59. PMC: 6257116. DOI: 10.3390/molecules15010442. View

10.

Ueland P, McCann A, Midttun O, Ulvik A . Inflammation, vitamin B6 and related pathways. Mol Aspects Med. 2016; 53:10-27. DOI: 10.1016/j.mam.2016.08.001. View

11.

Elinav E, Nowarski R, Thaiss C, Hu B, Jin C, Flavell R . Inflammation-induced cancer: crosstalk between tumours, immune cells and microorganisms. Nat Rev Cancer. 2013; 13(11):759-71. DOI: 10.1038/nrc3611. View

12.

Zhao L, Shu X, Li H, Gao J, Han L, Wang J . Prospective cohort studies of dietary vitamin B6 intake and risk of cause-specific mortality. Clin Nutr. 2018; 38(3):1180-1187. PMC: 6551204. DOI: 10.1016/j.clnu.2018.04.016. View

13.

Patterson C, Blankenberg S, Ben-Shlomo Y, Heslop L, Bayer A, Lowe G . Which biomarkers are predictive specifically for cardiovascular or for non-cardiovascular mortality in men? Evidence from the Caerphilly Prospective Study (CaPS). Int J Cardiol. 2015; 201:113-8. PMC: 4612445. DOI: 10.1016/j.ijcard.2015.07.106. View

14.

Cui Q, Zhu X, Guan G, Hui R, Zhu L, Wang J . Associations of vitamin B6 turnover rate with the risk of cardiovascular and all-cause mortality in hypertensive adults. Nutr Metab Cardiovasc Dis. 2023; 33(6):1225-1234. DOI: 10.1016/j.numecd.2023.03.017. View

15.

Hansson G, Libby P . The immune response in atherosclerosis: a double-edged sword. Nat Rev Immunol. 2006; 6(7):508-19. DOI: 10.1038/nri1882. View

16.

Ueland P, Ulvik A, Rios-Avila L, Midttun O, Gregory J . Direct and Functional Biomarkers of Vitamin B6 Status. Annu Rev Nutr. 2015; 35:33-70. PMC: 5988249. DOI: 10.1146/annurev-nutr-071714-034330. View

17.

Yang D, Liu Y, Wang Y, Ma Y, Bai J, Yu C . Association of Serum Vitamin B6 with All-Cause and Cause-Specific Mortality in a Prospective Study. Nutrients. 2021; 13(9). PMC: 8472743. DOI: 10.3390/nu13092977. View

18.

Nix W, Zirwes R, Bangert V, Kaiser R, Schilling M, Hostalek U . Vitamin B status in patients with type 2 diabetes mellitus with and without incipient nephropathy. Diabetes Res Clin Pract. 2014; 107(1):157-65. DOI: 10.1016/j.diabres.2014.09.058. View

19.

Johnson C, Paulose-Ram R, Ogden C, Carroll M, Kruszon-Moran D, Dohrmann S . National health and nutrition examination survey: analytic guidelines, 1999-2010. Vital Health Stat 2. 2014; (161):1-24. View

20.

Stover P, Field M . Vitamin B-6. Adv Nutr. 2015; 6(1):132-3. PMC: 4288272. DOI: 10.3945/an.113.005207. View